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Instant evaluation of contrast enhanced endoscopic ultrasound helps to differentiate various solid pancreatic lesions in daily routine

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World Journal of Clinical Cases 2019年第1期7卷 19-27页

作者： Klaus Kannengiesser Reiner Mahlke Frauke Petersen Anja Peters Torsten Kucharzik christian maaser Department of General Internal Medicine and Gastroenterology University Teaching Hospital Lueneburg Department of Pathology University Teaching Hospital Lueneburg

BACKGROUND Contrast enhanced harmonic endoscopic ultrasound(CEH-EUS) is a spreading technique; some studies have shown its value in the diagnosis of pancreatic adenocarcinoma using quantitative *** To examine the value of CEH-EUS for differentiating various pancreatic lesions in everyday routine with qualitative and quantitative *** Data of 55 patients with pancreatic lesions who underwent CEH-EUS were analysed retrospectively. Perfusion characteristics were classified by the investigator qualitatively immediately upon investigation, quantitative analysis was performed later on. Samples from fine needle aspiration(EUS-FNA) or surgical specimen served as gold *** CEH-EUS showed 39 hypoenhanced lesions, 3 non-enhanced and 13 hyperenhanced lesions. Concordance of the investigators qualitative classification of peak contrast enhancement with quantitative analysis later on was 100%, while other parameters such as arrival time, time to peak or area under the curve did not show additional value. 34 of 39 hypoenhanced lesions were pancreatic adenocarcinoma; of the hyperenhanced lesions 4 were inflammatory, 3 neuroendocrine carcinomas, 1 lymphoma, 1 insulinoma and 4 metastases(2 of renal cell carcinoma, 2 of lung cancer). Non-enhanced lesions showed up as necroses. Sensitivity for the detection of pancreatic adenocarcinoma was 100%,specificity 87.2% for hypoenhancement alone; in otherwise healthy pancreatic tissue all hypoenhanced lesions were pancreatic adenocarcinoma(sensitivity and specificity 100%, PPV and NPV for adenocarcinoma 100%).CONCLUSION This study again shows the excellent value of CEH-EUS in everyday routine for diagnostics of various focal pancreatic lesions suggesting that qualitatively assessed hypoenhancement is highly predictive for adenocarcinoma. Additional quantitative analysis of perfusion parameters does not add diagnostic yield. In case of the various hyperenhanced pancreatic lesions in our data set, histologic samp

关键词： Endoscopic ultrasound Contrast enhanced endoscopic ultrasound Pancreatic adenocarcinoma Neuroendocrine carcinoma Pancreatic metastases Lymphoma

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How to perform gastrointestinal ultrasound: anatomy and normal findings

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World Journal of Gastroenterology 2017年第38期23卷 6931-6941页

作者： Nathan S S Atkinson Robert V Bryant Yi Dong christian maaser Torsten Kucharzik Giovanni Maconi Anil K Asthana Michael Blaivas Adrian Goudie Odd Helge Gilja Dieter Nuernberg Dagmar Schreiber-Dietrich Christoph F Dietrich Translational Gastroenterology Unit Oxford University Hospitals NHS Foundation Trust School of Medicine University of Adelaide Department of Gastroenterology and Hepatology Royal Adelaide Hospital Department of Ultrasound Zhongshan Hospital Fudan University Ambulanzzentrum Gastroenterologie Klinikum Lüneburg Department of Gastroenterology Stadtisches Klinikum Luneburg gGmbH Gastrointestinal Unit Department of Biomedical and Clinical Sciences 'L.Sacco' University Hospital Department of Gastroenterology and Hepato-logy The Alfred Hospital Monash University Piedmont Hospital Department of Emergency Medicine Fremantle Hospital and Health Service Emergency Department National Centre for Ultrasound in Gastro- enterology Haukeland University Hospital Department of Clinical Medicine University of Bergen Department of Gastroenterology Brandenburg Medical School Med. Klinik 2 Caritas-Krankenhaus Bad Mergentheim

Gastrointestinal ultrasound is a practical, safe, cheap and reproducible diagnostic tool in inflammatorybowel disease gaining global prominence amongst clinicians. Understanding the embryological processes of the intestinal tract assists in the interpretation of abnormal sonographic findings. In general terms, the examination principally comprises interrogation of the colon, mesentery and small intestine using both lowfrequency and high-frequency probes. Interpretation of findings on GIUS includes assessment of bowel wall thickness, symmetry of this thickness, evidence of transmural changes, assessment of vascularity using Doppler imaging and assessment of other specific features including lymph nodes, mesentery and luminal motility. In addition to B-mode imaging, transperineal ultrasonography, elastography and contrast-enhanced ultrasonography are useful adjuncts. This supplement expands upon these features in more depth.

关键词： Ultrasound Intestinal Inflammatory bowel disease Guidelines Teaching

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外周苯二氮受体配体诱导人肝癌细胞的凋亡和细胞周期停滞,提高了紫杉醇、紫杉萜、阿霉素和Bcl-2抑制剂HA14-1的化疗敏感性

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世界核心医学期刊文摘（胃肠病学分册） 2005年第4期1卷 59-60页

作者： Sutter A.P. maaser K. Grabowski P. 姜志茹

Hepatocellular carcinoma (HCC) is one of the most common causes of cancer deaths worldwide. Thus, novel therapies are urgently needed. A promising approach is the use of peripheral benzodiazepine receptor (PBR) ligands which inhibit the proliferation of various tumors. PBR expression both in human HCC cell lines and in tumor specimens of HCC patients was analyzed by RT-PCR and immunostaining. To evaluate PBR ligands for the treatment of HCC, we tested their effects on human HCC cells. PBR was localized to the mitochondria both of HCC cell lines and tumor tissues of HCC patients. In contrast, normal liver did not express PBR. PBR ligands inhibited the proliferation of HCC cell lines by inducing apoptosis and cell cycle arrest. Apoptosis was characterized by a breakdown of the mitochondrial membrane potential, caspase-3 activation and nuclear degradation. Furthermore, pro-apoptotic Bax was overexpressed while anti-apoptotic Bcl-2 and Bcl-XL were suppressed. Cell cycle was arrested both at the G1/S-and G2/M-checkpoints. Synergistic anti-neoplastic effects were obtained by a combination of PBR ligands with cytostatic drugs (paclitaxel, docetaxel, doxorubicin), or with an experimental Bcl-2 inhibitor. This is the first report on the induction of apoptosis and cell cycle arrest by PBR ligands in HCC cells. Moreover, PBR ligands sensitized HCC cells to taxans and doxorubicin.

关键词：人肝癌细胞 HA14-1 紫杉萜苯二氮受体细胞周期化疗敏感性细胞系肝细胞癌线粒体膜电位治疗作用

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